Provider Demographics
NPI:1053643262
Name:CAMELLO, LILINA R (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LILINA
Middle Name:R
Last Name:CAMELLO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1286
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93423-1286
Mailing Address - Country:US
Mailing Address - Phone:805-423-1943
Mailing Address - Fax:
Practice Address - Street 1:7730 MORRO RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4413
Practice Address - Country:US
Practice Address - Phone:805-423-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist